Basic symptoms and the prediction of first-episode psychosis

Recent focus on early detection and intervention in psychosis has renewed interest in subtle psychopathology beyond positive and negative symptoms. Such self-experienced sub-clinical disturbances are described in detail by the basic symptom concept. This review will give an introduction into the concept of basic symptoms and describe the development of the current instruments for their assessment, the Schizophrenia Proneness Instrument, Adult (SPI-A) and Child and Youth version (SPI-CY), as well as of the two at-risk criteria: the at-risk criterion Cognitive-Perceptive Basic Symptoms (COPER) and the high-risk criterion Cognitive Disturbances (COGDIS). Further, an overview of prospective studies using both or either basic symptom criteria and transition rates related to these will be given, and the potential benefit of combining ultra-high risk criteria, particularly attenuated psychotic symptoms, and basic symptom criteria will be discussed. Finally, their prevalence in psychosis patients, i.e. the sensitivity, as well as in general population samples will be described. It is concluded that both COPER and COGDIS are able to identify subjects at a high risk of developing psychosis. Further, they appear to be sufficiently frequent prior to onset of the first psychotic episode as well as sufficiently rare in persons of general population to be considered as valuable for an early detection of psychosis.

Basic symptoms in the general population and in psychotic and non-psychotic psychiatric adolescents

Cognitive-perceptive 'basic symptoms' are used complementary to ultra-high-risk criteria in order to predict onset of psychosis in the pre-psychotic phase. The aim was to investigate the prevalence of a broad selection of 'basic symptoms' in a representative general adolescent population sample (GPS; N=96) and to compare it with adolescents first admitted for early onset psychosis (EOP; N=87) or non-psychotic psychiatric disorders (NP; N=137).

Being Open, Being Faithful: The Journey of Interreligious Dialogue

What does Christian identity mean in the face of religious pluralism? In some ways, the frontier of global Christianity lies not in repairing its past divisions so much as bravely facing its future in a world of many other faiths and conflicting convictions. Being Open, Being Faithful is a brief history, astute analysis, and trustworthy guide for Christian encounters in this pluralistic environment. A central argument of this perceptive book is that interreligious dialogue has moved so far as to fundamentally change the attitudes and openness of world religious traditions to each other, promising a future more open and less hostile than one might otherwise think. The book presents and reflects on the recent history of interreligious encounter and dialogue, and it traces the manifold difficulties involved, especially as they are experienced in Roman Catholic and World Council of Churches' engagements with other faiths. Yet, it goes even further: along with the history of such encounters, Being Open, Being Faithful examines the issue of Christian discipleship in the context of interfaith engagement, the operative models, the thorny issue of core theological commitments, and what might be the shape of Christian identity in light of such encounters.

Das Werk als Feige und als Figur. Ambivalenzen der Rezeption zwischen Valéry, Mallarmé, "Tel Quel" und Francis Ponge

L’œuvre poétique de Valéry est caractérisée par une esthétique de la perfection, de la pureté et de la clôture. La série ouverte et hétérogène des "Cahiers", en revanche, ne se laisse guère ranger dans la catégorie de l’œuvre. Selon Valéry, la réorientation intellectuelle à la base de cette opposition est due au "choc" subi par la découverte de l’œuvre mallarméenne. Les divers écrits valéryens sur Mallarmé nous servent à reconstruire cette relation ambivalente et nous aident à éclairer sa conception non moins ambivalente de l’œuvre d’art. Nous soutenons que ce ne sont pas ses propres travaux, mais les poésies de Mallarmé qui lui semblaient des œuvres achevées à proprement parler. Pour décrire l’expérience de perfection et d’achèvement que lui fournit la lecture du "Coup de dés", Valéry se sert de la notion de figure qui, entre autres, comporte des associations géométriques. Sous la forme d’un hommage ambivalent, Francis Ponge oppose aux concepts valéryens de figure et d’œuvre d’art une poétique de l’objet matériel et concret qui s’incarne dans "La figue (sèche)", publiée en 1960 comme pièce inaugurale de la revue "Tel Quel".

Age matters in the prevalence and clinical significance of ultra-high-risk for psychosis symptoms and criteria in the general population: Findings from the BEAR and BEARS-kid studies

Early detection of psychosis is an important topic in psychiatry. Yet, there is limited information on the prevalence and clinical significance of high-risk symptoms in children and adolescents as compared to adults. We examined ultra-high-risk (UHR) symptoms and criteria in a sample of individuals aged 8-40 years from the general population of Canton Bern, Switzerland, enrolled from June 2011 to May 2014. The current presence of attenuated psychotic symptoms (APS) and brief intermittent psychotic symptoms (BLIPS) and the fulfillment of onset/worsening and frequency requirements for these symptoms in UHR criteria were assessed using the Structured Interview for Psychosis Risk Syndromes. Additionally, perceptive and non-perceptive APS were differentiated. Psychosocial functioning and current non-psychotic DSM-IV axis I disorders were also surveyed. Well-trained psychologists performed assessments. Altogether, 9.9% of subjects reported APS and none BLIPS, and 1.3% met all the UHR requirements for APS. APS were related to more current axis I disorders and impaired psychosocial functioning, indicating some clinical significance. A strong age effect was detected around age 16: compared to older individuals, 8-15-year olds reported more perceptive APS, that is, unusual perceptual experiences and attenuated hallucinations. Perceptive APS were generally less related to functional impairment, regardless of age. Conversely, non-perceptive APS were related to low functioning, although this relationship was weaker in those below age 16. Future studies should address the differential effects of perceptive and non-perceptive APS, and their interaction with age, also in terms of conversion to psychosis.

Revisiting the Basic Symptom Concept: Toward Translating Risk Symptoms for Psychosis into Neurobiological Targets

In its initial formulation, the concept of basic symptoms (BSs) integrated findings on the early symptomatic course of schizophrenia and first in vivo evidence of accompanying brain aberrations. It argued that the subtle subclinical disturbances in mental processes described as BSs were the most direct self-experienced expression of the underlying neurobiological aberrations of the disease. Other characteristic symptoms of psychosis (e.g., delusions and hallucinations) were conceptualized as secondary phenomena, resulting from dysfunctional beliefs and suboptimal coping styles with emerging BSs and/or concomitant stressors. While BSs can occur in many mental disorders, in particular affective disorders, a subset of perceptive and cognitive BSs appear to be specific to psychosis and are currently employed in two alternative risk criteria. However, despite their clinical recognition in the early detection of psychosis, neurobiological research on the aetiopathology of psychosis with neuroimaging methods has only just begun to consider the neural correlate of BSs. This perspective paper reviews the emerging evidence of an association between BSs and aberrant brain activation, connectivity patterns, and metabolism, and outlines promising routes for the use of BSs in aetiopathological research on psychosis.